Concise MRCP

I've noticed that lots of people have started using the term "past pointing" incorrectly when they actually mean "intention tremor"

Intention tremor = wobbly finger when finger outstretched in cerebellar syndrome (and when returning to touch nose)

Past pointing = accidentally pointing at a ghost image by a patient who has new diplopia

If you are demonstrating cerebellar syndrome, use the term intention tremor

If a patient has diplopia, it is the outermost image that is the abnormal image.

Cover each eye in turn

If the inner image disappears, you have covered the good eye.
Cover the alternate eye, the outermost image should now disappear.

If the same image disappears then the diplopia is non-organic

Causes of MAHA

DIC (most common)
TTP (elderly neuro) and HUS (young and renal)
HELLP (Pregnant)
Malignant hypertension

There is hairy Cushing's syndrome and smooth Cushing's syndrome

ACTH driving Cushing's syndrome also promotes the secretion of androgens making you hairy (pituitary or ectopic)

Adrenal or exogenous steroids suppress ACTH, reducing androgens causing loss of hair - resulting in a smooth (hairless) Cushing's syndrome

Loop diuretics work on the thick ascending limb as Na-K-2Cl cotransporters

It is more simple than it sounds

They pump out NaCl (sodium chloride) & KCl (potassium

This is made to sound more sexy by putting the Na and K on one side of its name and the 2 clorides on the other.